B.C. initiative to find a GP for every patient lags

by Tristan Bronca on June 23, 2015 – Medical Post

When the GP for Me initiative was announced in 2010, the health minister at the time made the rather ambitious proclamation that every British Columbian who was looking for a family doctor would find one by 2015. Five years later, 700,000 British Columbians remain without a doctor and 200,000 are still actively looking.

Now, the joint initiative spearheaded by the government and Doctors of BC has drawn criticism. Dr. Bill Cavers, the outgoing president of Doctors of BC, even admitted that the program has slid backwards. At the outset, 13% of British Columbians didn’t have a family doctor, but in April Dr. Cavers told the CBC that figure had risen to 16%.
“It’s a work in progress,” Dr. Charles Webb, the incoming president of Doctors of BC (formerly the British Columbia Medical Association), told the Medical Post in an interview. Still, despite acknowledging the shortcomings of the program, Dr. Webb was unabashedly optimistic about it.

“The bottom line is that 95% of patients who have been actively looking for a family physician have gotten one,” he said. He couldn’t say when the program would meet the target that was originally set for this year, but he did suggest that GP for Me was over its initial growing pains.

“At one point . . . the GP for Me project required an enormous amount of research into where doctors were working, how they were working, and what space they might have in their practices to take on new patients,” Dr. Webb said. “More than that, (the association was looking at) what those doctors would need to become more efficient, to attach more patients to their practice and service them well.”

Now there are attachment initiatives in 33 of the 34 divisions of family practice across the province. With Dr. Webb’s term as president just beginning, he’s laid out several priorities in hopes of bringing the province closer to accomplishing its seemingly distant goal.

When Doctors of BC reached its last master agreement, the province set aside funding for processes to ensure patients are referred to doctors who are in a position to take them on.

“They’re using staff at the divisions to make sure a patient is a good fit for the doctor they’re being referred to,” said Dr. Webb. “It wouldn’t be like in the middle of the day when you’re seeing a patient every 10 or 15 minutes and suddenly you’ve got a brand new patient in front of you who’s complicated, difficult, with long-term problems.”
Instead, in some of the family practice divisions, the process has become more sophisticated. Doctors who participate in the initiative are evaluated (Dr. Webb will also participate in this) while patients go through an intake process to have their medical needs assessed. Then, with their consent, a package containing their background information is sent to a physician who has been deemed a good fit, giving that physician time to incorporate the information into an electronic record before the first visit.

In B.C.’s last master agreement, the province also allocated $2,000 to $3,000 per doctor in B.C. to bolster clinic staff. While that amount is not enough to bring on an additional full-time staff member at an individual practice, the additional funding will support longer hours for clinic staff or a part-time staffer. The idea is that if a nurse spends 10 to 15 minutes with a patient, the physician may be able to conduct an entire visit in five minutes, Dr. Webb said. “If it was just me on my own, it would take me a half an hour to sort that patient out,” he continued. The result is not only a roster with space for additional patients, but better care for the patients already there, said Dr. Webb.
Dr. Webb’s direction

Dr. Webb has oriented his presidency around ideals like engagement, opportunity, fairness and collaboration. But if his politics are any indication, these abstractions are not just guiding principles. They’re goals he wants to help the organization achieve.

During his inauguration speech at a luncheon following the Doctors of BC general assembly, Dr. Webb said delays in access to care are, plainly and simply, unfair. His proposed solution is greater collaboration, one of the keys to which seems to be engagement.

There have been several recent developments that constitute marked progress on these fronts. Several health authority CEOs recently signed off on joint committees, allowing government health representatives and physicians to come together to address local issues in each of the divisions—something that, according to Dr. Webb, has never been attempted before in Canada.

He also pointed out that young doctors and medical students have also begun to apply for committee and board positions within Doctors of BC, and the voter turnout in the last election of 20% was the highest in the last 15 years.
All this is good for the association’s strategy, which requires “highly engaged doctors who can work with partners in the health-care system to exert a meaningful influence,” Dr. Webb said in his speech.
It might not have an immediate or measurable impact on the number of patients who have a family doctor, but Dr. Webb seems to think things are moving in the right direction. As he said just one day earlier: “I couldn’t be coming in at a better time.”